To evaluate the efficacy of a commercially available acetabular positioning device, we performed a prospective evaluation of 40 consecutive patients undergoing primary total hip arthroplasty. All surgery was performed by the same surgeon, in the same operating room, and on the same operating table. The acetabular positioning device was designed to place the component in 45° of abduction. At 6 weeks, all radiographs were evaluated by 3 investigators not involved with the surgery. Each radiograph was evaluated by each reviewer on 3 separate occasions, blinded to the findings of the other reviewer to assess interobserver and intraobserver variability. The mean cup abduction angle was 42.1°, with a range from 23° to 57° (SD 8.3°). Intraobserver and interobserver variability were 0.2 and 0.3°, respectively. The findings of this study demonstrate a wide variability in acetabular cup placement in primary total hip arthroplasty. We believe this is due to movement of the pelvis, which may occur during preparation, draping, and retracting during surgery. We feel surgeons should not rely solely on positioning devices when implanting the acetabular component in total hip arthroplasty. Identification of bone landmarks and determination of superolateral implant coverage noted on preoperative templating is advocated to improve the precision of component position.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
KR Schulte JJ Callaghan S Kelley RJ Johnston (1993) ArticleTitleThe outcome of Charnley total hip arthroplasty with cement after a minimum twenty-year follow-up J Bone Joint Surg Am 75 961–975 Occurrence Handle8240489
RL Barrack (2003) ArticleTitleDislocation after total hip arthoplasty: Implant design and orientation J Am Acad Orthop Surg 11 IssueID2 89–99 Occurrence Handle12670135
JG Kennedy WB Rogers KE Soffe RJ Sullivan DG Griffen LJ Sheehan (1998) ArticleTitleEffects of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear and component migration J Arthroplasty 13 IssueID5 530–534 Occurrence Handle10.1016/S0883-5403(98)90052-3 Occurrence Handle9726318
M Kligman M Roffman (2002) ArticleTitleThe effect of abduction differences between cup and contralateral acetabular angle on polyethylene component wear Orthopaedics 25 IssueID1 65–67
GE Lewinnek JL Lewis R Tarr (1978) ArticleTitleDislocations after total hip replacement arthroplasties J Bone Joint Surg Am 60 217–220 Occurrence Handle641088
FJ Kummer S Shah S Iyer PE DiCesare (1999) ArticleTitleThe effect of acetabular cup orientations on limiting hip rotation J Arthroplasty 14 IssueID4 509–513 Occurrence Handle10.1016/S0883-5403(99)90110-9 Occurrence Handle10428235
AG Gonzalez Della Valle G Slullitel F Piccaluga EA Salvati (2005) ArticleTitleThe precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty J Arthroplasty 20 IssueID1 51–58
DE Padgett L Kull AG Rosenberg R Sumner JO Galante (1993) ArticleTitleRevision of the acetabular component without cement after total hip arthroplasty J Bone Joint Surg Am 75 663–673 Occurrence Handle8501081
P Massin L Schmidt CA Engh (1989) ArticleTitleEvaluation of cementless acetabular component migration: an experimental study J Arthroplasty 4 245–249 Occurrence Handle2795031
B Jaramaz AM DiGioia M Blackwell C Nickou (1998) ArticleTitleComputer assisted measurement of cup placement in total hip replacement Clin Orthop Relat Res 354 70–81 Occurrence Handle10.1097/00003086-199809000-00010 Occurrence Handle9755766
M Nogler O Kessler A Prassl B Donnelly R Streicher JB Sledge (2004) ArticleTitleReduced variability of acetabular cup positioning with use of an imageless navigation system Clin Orthop Relat Res 426 159–163 Occurrence Handle10.1097/01.blo.0000141902.30946.6d Occurrence Handle15346068
This work was approved by the Institutional Review Board and Clinical Investigation Department (S90-072). The authors would like to thank the section of biomechanics for their help in this work.
About this article
Cite this article
Padgett, D.E., Hendrix, S.L., Mologne, T.S. et al. Effectiveness of an Acetabular Positioning Device in Primary Total Hip Arthroplasty. HSS Jrnl 1, 64–67 (2005). https://doi.org/10.1007/s11420-005-0109-z
- Acetabular Component
- Pelvic Rotation
- Operating Room Table
- Preoperative Templating
- Acetabular Component Position